Provider Demographics
NPI:1689841397
Name:GLOBAL REHAB ASSOCIATES
Entity Type:Organization
Organization Name:GLOBAL REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:479-967-7257
Mailing Address - Street 1:2807 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-9067
Mailing Address - Country:US
Mailing Address - Phone:479-967-7257
Mailing Address - Fax:479-967-7257
Practice Address - Street 1:2807 W 19TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-9067
Practice Address - Country:US
Practice Address - Phone:479-967-7257
Practice Address - Fax:479-967-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT13232251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR135683742Medicaid